Doctor Answers 10

Forehead Scar

December 2nd, 2010

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The picture submitted shows a moderately hyperpigmented albeit favorably placed horizontal scar, parallel to relaxed skin tension lines (frown lines) If the scar is not significantly depressed, I would suggest use of hydroquinone (bleaching cream) and sunblock (spf > 30). If the scar is depressed or wide, excision and closure may be of benefit. Given the pigmentation in your skin type, I would be cautious with the use of any laser and understand that the possibility of further hyperpigmentation exists with any excisional technique.

Scar Treatment: Common Questions

January 4th, 2011

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Your scar is hyperpigmented, but in a favorable direction. I would recommend holding off on any surgical interventions and treat with retin-A, hydroquinone, and avoidance of sun exposure. The main concern is creating a larger or darker injury - so be conservative and patient.

Manual Dermasanding and Medical Microneedling Are Two Effective Ways of Dealing With Scars

December 12th, 2010

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Scars may result from injury, trauma, surgery, severe inflammation (such as from nodulocystic acne) or infection (e.g. chicken pox scars). No scar, once fully formed, can be totally erased. But there are a couple of different treatments that I have found extremely effective for improving them.

One technique, known as scarabrasion, is particularly effective for treating relatively fresh scars, i.e. those that have resulted from any of the above processes within the previous three months. Manual dermasanding, which uses what amounts to sterilized, high grade sandpaper, to abrade the surface of the young scar and the surrounding skin (under local anesthesia), when performed within this critical period, may significantly improve the appearance of the scar, and in some instances almost erase it.

For older scars, i.e. those well beyond this critical three month period, I have found medical microneedling to be quite useful. In this procedure, which is performed under local, a roller device containing many fine, almost microneedles, is rolled back and forth over the scar to break it up and to promote the sythesis of fresh, non-scar collagen. Several treatments, spaced at six week intervals, are often required, to significantly improve and fade the scar.

Scar Removal Pictures

Scar on forehaed

December 9th, 2010

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Most likely the best treatment would be mild CO2 lasering either one or two treatments. Recutting a scar that is going in the right direction and where it will eventually look like a natural line is foolish .Most likely any surgical revision will leave you with essentially the same thing. Laser can get great results the limiting factor is skin tone. The lighter your natural tone the more likely you are to get an even match post-laser. The darker your skin tone the more likely you are to get hyperpigmentation problems. Unless the scar is elevated and/or red and inflammed a steroid shot or silicone sheeting is of no value. You can consider bleaching the hyperpigmented area or use on of the ipl lasers to depigment it

Scar on Forehead

December 6th, 2010

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Thanks for the picture of your scar included in with your question! It shows a slightly hyperpigmented (dark colored) scar located over the middle of your forehead; it is horizontally/transversely positioned and is parallel to relaxed skin tension lines (frown lines) which are normal across your forehead (just raise your eyebrows to see them). The importance of this orientation means that in time it will blend into the normal lines and creases across your forehead and become virtually impossible to see.

If the scar is not significantly depressed, I would suggest use of hydroquinone (bleaching cream) and aggressive use of sunblock (spf at least 30).

However, if the scar is depressed or casts a shadow in certain light, surgical re-excision and meticulous closure by a (facial) plastic surgeon may help fill in the area. Given the pigmentation in your skin type, I would be cautious with the use of any laser as further "injury" to the area (via laser) may cause hyperpigmentation to recur or even worsen.

For dark scars, sometimes its better to wait and watch.

December 3rd, 2010

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Your scar appears flat but darkly pigmented. A bleaching cream with 4% hydroquinone and tretinoin for several months is probably your best bet. Wish your skin type any type of physical treatment may make it even darker. Time should lighten it as well.

Forehead scar

December 2nd, 2010

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It is difficult to assess from this one picture but it appears hyperpigmented and efforts to bleach the area may be beneficial. If it is red, IPL treatments may also be beneficial. Occasionally dermabrasion may be useful as well.

Removing a Dark Forehead Scar

December 2nd, 2010

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The appearance of the scar depends on its :
- Location (some areas heal less conspicuously than others)
- Orientation ( a scar oriented in the direction of the future skin wrinkle lines will appear much nicer than scars oriented in opposite directions
- Mechanism of injury (sharp (knife etc) cuts heal nicer than blunt (burst injuries) as when hit by weights or dumbbells).
- Repair (if the wound is allowed to heal by itself it would NOT look as good as if the wound edges were trimmed away and the wound was closed under no tension with proper stitching).
- Genetics (some people heal "better" than others.. Darker skinned individuals are prone to raised and darker scars).
In your case, I would use a bleaching cream for a few months and avoid sun exposure. Analyze the scar at 6 months. If you are happy, I wold then leave it alone. If you are still unhappy, I would have the scar surgically excised and revised by a Plastic surgeon. The result will be superior.
Dr. Peter Aldea

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